Pregnancy: Should I Have an Early Fetal Ultrasound

Guides you through the decision to have an early fetal ultrasound. Explains when ultrasound is usually done during pregnancy and why. Lists risks and benefits. Includes interactive tool to help you decide.

Pregnancy: Should I Have an Early Fetal Ultrasound?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Your options

Have an early fetal ultrasound, before 18 to 20 weeks of
pregnancy.

Don't have an early fetal ultrasound.

Key points to remember

Fetal ultrasound is usually done during
pregnancy to check the age, size, and position of your baby. Most of the time
it is done at about 18 to 20 weeks. If you are sure of your last menstrual
period and don't have any risk factors for birth defects, you probably don't
need to have this test any earlier.

Your doctor may recommend an
early ultrasound if there is a need to find out exactly how long you have been
pregnant, if you are having unusual symptoms such as bleeding, or if you have
had abnormal results from another test.

An early ultrasound may
show a problem that goes away on its own or isn't important to your or your
baby's health. If that happens, you may need to have other tests to find if
there really is a problem.

Some "keepsake video" centers sell
ultrasound videos as your baby's first photo. But these centers may use the
ultrasound machine at a higher energy level and for longer times than is safe.
The Food and Drug Administration advises against getting a fetal ultrasound if
you don't have a medical reason.

Fetal ultrasound uses sound waves to make pictures of the fetus and
placenta inside the uterus. The test is the safest way
to find out the age, size, and position of your baby. During the test, a small
handheld device called a transducer is passed over your belly. If ultrasound is
done before the 11th week of pregnancy, a transducer shaped to fit inside your
vagina may be used.

Fetal ultrasound is usually done at about 18
to 20 weeks of pregnancy. If you are sure of your last menstrual period and
don't have any risk factors for birth defects, you probably don't need to have
this test any earlier.

A combination of tests that includes
ultrasound may be done during your first
trimester to check for
Down syndrome. This
first-trimester screening test is different from the routine
ultrasound that is usually done at about 18 weeks of pregnancy. It uses an ultrasound measurement of the
thickness of the skin at the back of the baby's neck (nuchal translucency).

If your doctor recommends that you have an early fetal ultrasound (before
18 to 20 weeks), the test may give you some useful information.

If the test doesn't show any problems, you
may feel more at ease during your pregnancy.

If you learn that you
are carrying more than one baby, you and your doctor can plan ahead for a
healthy pregnancy and delivery.

If you
find out that the baby has a problem, then you, your partner, and your doctor
can talk about your choices. The first step may be to repeat the ultrasound or
have other tests to confirm the results.

Some problems can be treated soon after
the baby is born. They may not seriously affect your baby's life. You may be
able to plan your delivery in a hospital that offers special care for sick
newborns.

Some problems, such as certain types of
neural tube defects and
Down syndrome, may not be fatal. But they will affect
your baby for his or her entire life.

In rare cases a defect is so
severe that the baby may not survive the pregnancy or may die soon after birth.

Sometimes a possible defect is suspected but not confirmed, and
the baby is born perfectly healthy.

The decision about what to do if you find out that you
are carrying a baby with a severe defect is very personal. Some women who learn
that their baby has a serious defect choose to end their pregnancy. Others make
plans for raising a sick or disabled child.

Fetal ultrasound is a safe test when it's performed for medical reasons
by a trained ultrasound technologist or a doctor.1

Abnormal results from an early fetal ultrasound can cause a lot of
stress and anxiety. For example:

They can require more tests to find out if
there really is a problem. You might need another ultrasound or
amniocentesis. Most of the time, the results from
these extra tests are normal. But extra tests can carry risks. Amniocentesis
has more risks than ultrasound, including a very small risk of
miscarriage.

They can show a problem that goes away later in your
pregnancy.

They may show a serious problem when there isn't one.
But you may need more tests before you know this for sure. It can be stressful
while you wait to find out.

Some "keepsake video" centers sell ultrasound videos as
your baby's first photo. But these centers may use the ultrasound machine at a
higher energy level and for longer times than is safe. The U.S. Food and Drug
Administration advises against getting a fetal ultrasound unless there is a
medical reason.

If you don't have an early ultrasound, there is a
slight chance that you may not find out until later that:

You are carrying more than one baby.

Your baby has a birth defect. In rare cases, a defect is so severe
that the baby may not survive the pregnancy or may die soon after birth. Some
women choose to end a pregnancy rather than suffer a stillbirth or death of a
newborn.

Personal stories about early fetal ultrasound

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

Raoul and I
talked for a long time about this pregnancy and what having a baby would mean
to us. For personal reasons, we would not choose to end the pregnancy if there
was a problem with the baby. So we decided not to do any prenatal diagnostic
tests unless something goes wrong. We trust that whether the baby is perfect or
not, it will be the baby (or babies!) that we are meant to have. Our families
think that our approach is a little unusual, but we are both comfortable with
our decision.

Rita, age
24

I guess that you could call me a bit of a
worrywart. I just know that I will feel better if I can actually see the baby
on the monitor and see its little heart beating and have that one more bit of
information to reassure me that everything is okay.

Rachel, age 33

My sister
had a healthy baby boy last spring after spending most of her pregnancy
worrying that everything was not okay with the baby. She had an ultrasound that
showed a cyst in the baby's brain. The cyst went away, and her doctor said that
they are really common and almost never cause a problem, but the whole
experience was really stressful for her and her husband. At one point they even
wondered if they should end the pregnancy. So now that I'm pregnant, I feel
torn. If there is a problem, I think I would want to know, but a false alarm
would be so stressful! I think the worry would be worse for me and the baby
than any problem.

Melissa, age 32

I read a lot about prenatal testing,
including ultrasound, so I know what it can and can't show about the baby. My
doctor says that because of my age and our family histories, there is very
little chance that there are any problems with the baby (although we understand
that no one can ever be sure about this). So I know there really isn't any
reason to have the ultrasound ... but this is the only child we plan to have,
and I want to have the whole pregnancy experience, ultrasound and
all.

Julie, age
25

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

I want to have an early picture of my baby to show my friends and family.

I don't want to have a test I don't need.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having an early fetal ultrasound

NOT having an early fetal ultrasound

Leaning toward

Undecided

Leaning toward

What else do you need to make your decision?

Check the facts

1.

If you're curious about what your baby looks like, is it okay to get an early fetal ultrasound?

YesSorry, that's not right. The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.

NoYou're right. The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.

I'm not sureIt may help to go back and read "What are the risks of an early fetal ultrasound?" The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.

2.

Are bleeding or abnormal results from another test reasons to have an early fetal ultrasound?

YesYou're right. Your doctor may recommend an early ultrasound if you are having bleeding or if you have abnormal results from another test.

NoSorry, that's not right. Your doctor may recommend an early ultrasound if you are having bleeding or if you have abnormal results from another test.

I'm not sureIt may help to go back and read "Why might your doctor recommend an early fetal ultrasound?" Bleeding and abnormal test results are two reasons for having an early ultrasound.

3.

If a problem is seen on early ultrasound, can you be sure it is serious and important?

YesSorry, that's not right. An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health.

NoYou're right. An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health.

I'm not sureIt may help to go back and read "What are the risks of an early fetal ultrasound?" An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health.

American Institute of Ultrasound in Medicine (2007). AIUM practice guideline
for the performance of
obstetric ultrasound
examinations. Available online: http://www.aium.org/publications/guidelines.aspx.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Pregnancy: Should I Have an Early Fetal Ultrasound?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Have an early fetal ultrasound, before 18 to 20 weeks of
pregnancy.

Don't have an early fetal ultrasound.

Key points to remember

Fetal ultrasound is usually done during
pregnancy to check the age, size, and position of your baby. Most of the time
it is done at about 18 to 20 weeks. If you are sure of your last menstrual
period and don't have any risk factors for birth defects, you probably don't
need to have this test any earlier.

Your doctor may recommend an
early ultrasound if there is a need to find out exactly how long you have been
pregnant, if you are having unusual symptoms such as bleeding, or if you have
had abnormal results from another test.

An early ultrasound may
show a problem that goes away on its own or isn't important to your or your
baby's health. If that happens, you may need to have other tests to find if
there really is a problem.

Some "keepsake video" centers sell
ultrasound videos as your baby's first photo. But these centers may use the
ultrasound machine at a higher energy level and for longer times than is safe.
The Food and Drug Administration advises against getting a fetal ultrasound if
you don't have a medical reason.

FAQs

What is a fetal ultrasound?

Fetal ultrasound uses sound waves to make pictures of the fetus and
placenta inside the uterus. The test is the safest way
to find out the age, size, and position of your baby. During the test, a small
handheld device called a transducer is passed over your belly. If ultrasound is
done before the 11th week of pregnancy, a transducer shaped to fit inside your
vagina may be used.

Fetal ultrasound is usually done at about 18
to 20 weeks of pregnancy. If you are sure of your last menstrual period and
don't have any risk factors for birth defects, you probably don't need to have
this test any earlier.

A combination of tests that includes
ultrasound may be done during your first
trimester to check for
Down syndrome. This
first-trimester screening test is different from the routine
ultrasound that is usually done at about 18 weeks of pregnancy. It uses an ultrasound measurement of the
thickness of the skin at the back of the baby's neck (nuchal translucency).

How is information from an early fetal ultrasound used?

If your doctor recommends that you have an early fetal ultrasound (before
18 to 20 weeks), the test may give you some useful information.

If the test doesn't show any problems, you
may feel more at ease during your pregnancy.

If you learn that you
are carrying more than one baby, you and your doctor can plan ahead for a
healthy pregnancy and delivery.

If you
find out that the baby has a problem, then you, your partner, and your doctor
can talk about your choices. The first step may be to repeat the ultrasound or
have other tests to confirm the results.

Some problems can be treated soon after
the baby is born. They may not seriously affect your baby's life. You may be
able to plan your delivery in a hospital that offers special care for sick
newborns.

Some problems, such as certain types of
neural tube defects and
Down syndrome, may not be fatal. But they will affect
your baby for his or her entire life.

In rare cases a defect is so
severe that the baby may not survive the pregnancy or may die soon after birth.

Sometimes a possible defect is suspected but not confirmed, and
the baby is born perfectly healthy.

The decision about what to do if you find out that you
are carrying a baby with a severe defect is very personal. Some women who learn
that their baby has a serious defect choose to end their pregnancy. Others make
plans for raising a sick or disabled child.

What are the risks of an early fetal ultrasound?

Fetal ultrasound is a safe test when it's performed for medical reasons
by a trained ultrasound technologist or a doctor.1

Abnormal results from an early fetal ultrasound can cause a lot of
stress and anxiety. For example:

They can require more tests to find out if
there really is a problem. You might need another ultrasound or
amniocentesis. Most of the time, the results from
these extra tests are normal. But extra tests can carry risks. Amniocentesis
has more risks than ultrasound, including a very small risk of
miscarriage.

They can show a problem that goes away later in your
pregnancy.

They may show a serious problem when there isn't one.
But you may need more tests before you know this for sure. It can be stressful
while you wait to find out.

Some "keepsake video" centers sell ultrasound videos as
your baby's first photo. But these centers may use the ultrasound machine at a
higher energy level and for longer times than is safe. The U.S. Food and Drug
Administration advises against getting a fetal ultrasound unless there is a
medical reason.

What are the risks of not having an early fetal ultrasound?

If you don't have an early ultrasound, there is a
slight chance that you may not find out until later that:

You are carrying more than one baby.

Your baby has a birth defect. In rare cases, a defect is so severe
that the baby may not survive the pregnancy or may die soon after birth. Some
women choose to end a pregnancy rather than suffer a stillbirth or death of a
newborn.

Why might your doctor recommend an early fetal ultrasound?

Your doctor may recommend an early ultrasound if:

You have bleeding or other symptoms of
miscarriage.

You have risk factors for
birth defects. An ultrasound can check for birth defects that affect the baby's
brain and spinal cord.

There is a need to find out exactly how long
you have been pregnant.

You have had another test that suggests a
possible problem with the fetus.

2. Compare your options

Have early fetal
ultrasound

Don't have early fetal
ultrasound

What is usually involved?

Fetal ultrasound is usually done by an ultrasound
technologist or doctor in a doctor's office, hospital, or clinic. An early
fetal ultrasound is one that is done before 18 to 20 weeks of
pregnancy.

The test takes 15 to 60 minutes.

You wait until
18 to 20 weeks of pregnancy to have a routine ultrasound exam to check the age,
size, and position of your baby.

What are the benefits?

If the test doesn't
show any problems, you may feel more at ease during your pregnancy.

If the test shows that you are carrying more than one baby, you
can plan ahead for a healthy pregnancy and delivery.

If you find
out that your baby has a problem, you can discuss your options with your
partner and doctor.

You avoid the
stress and anxiety of an early fetal ultrasound.

You don't need extra tests to find out if there really is a
problem that may not be serious or that goes away later in your pregnancy.

What are the risks and side effects?

The
test can create a lot of stress and anxiety. For example, ultrasound may show a
problem that goes away later in your pregnancy.

You may need more
tests, such as
amniocentesis, to rule out or confirm a problem seen
with ultrasound.

Some "keepsake video" centers may not use
ultrasound at levels that are safe for your baby. You shouldn't have a fetal
ultrasound unless there is a medical reason.

You may not find out until later in your pregnancy
that:

You are carrying more than one
baby.

Your baby has a birth defect.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about early fetal ultrasound

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"Raoul and I talked for a long time about this pregnancy and what having a baby would mean to us. For personal reasons, we would not choose to end the pregnancy if there was a problem with the baby. So we decided not to do any prenatal diagnostic tests unless something goes wrong. We trust that whether the baby is perfect or not, it will be the baby (or babies!) that we are meant to have. Our families think that our approach is a little unusual, but we are both comfortable with our decision."

— Rita, age
24

"I guess that you could call me a bit of a worrywart. I just know that I will feel better if I can actually see the baby on the monitor and see its little heart beating and have that one more bit of information to reassure me that everything is okay."

— Rachel, age 33

"My sister had a healthy baby boy last spring after spending most of her pregnancy worrying that everything was not okay with the baby. She had an ultrasound that showed a cyst in the baby's brain. The cyst went away, and her doctor said that they are really common and almost never cause a problem, but the whole experience was really stressful for her and her husband. At one point they even wondered if they should end the pregnancy. So now that I'm pregnant, I feel torn. If there is a problem, I think I would want to know, but a false alarm would be so stressful! I think the worry would be worse for me and the baby than any problem."

— Melissa, age 32

"I read a lot about prenatal testing, including ultrasound, so I know what it can and can't show about the baby. My doctor says that because of my age and our family histories, there is very little chance that there are any problems with the baby (although we understand that no one can ever be sure about this). So I know there really isn't any reason to have the ultrasound ... but this is the only child we plan to have, and I want to have the whole pregnancy experience, ultrasound and all."

— Julie, age
25

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have an early fetal ultrasound

Reasons not to have an early fetal ultrasound

I need to know exactly how long I've been pregnant.

I already know how long I've been pregnant.

More important

Equally important

More important

I want to find out now if my baby has any birth defects.

I don't need to know right now if my baby has birth defects.

More important

Equally important

More important

I'm worried about some of my pregnancy symptoms, like bleeding.

I don't have any unusual symptoms.

More important

Equally important

More important

I want to have an early picture of my baby to show my friends and family.

I don't want to have a test I don't need.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having an early fetal ultrasound

NOT having an early fetal ultrasound

Leaning toward

Undecided

Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
If you're curious about what your baby looks like, is it okay to get an early fetal ultrasound?

Yes

No

I'm not sure

You're right. The Food and Drug Administration advises against getting a fetal ultrasound if you don't have a medical reason.

2.
Are bleeding or abnormal results from another test reasons to have an early fetal ultrasound?

Yes

No

I'm not sure

You're right. Your doctor may recommend an early ultrasound if you are having bleeding or if you have abnormal results from another test.

3.
If a problem is seen on early ultrasound, can you be sure it is serious and important?

Yes

No

I'm not sure

You're right. An early ultrasound may show a problem that goes away on its own or isn't important to your or your baby's health.

Decide what's next

1.
Do you understand the options available to you?

Yes

No

2.
Are you clear about which benefits and side effects matter most to you?

Yes

No

3.
Do you have enough support and advice from others to make a choice?

Yes

No

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all

Somewhat sure

Very sure

2.
Check what you need to do before you make this decision.

I'm ready to take action.

I want to discuss the options with others.

I want to learn more about my options.

3.
Use the following space to list questions, concerns, and next steps.

Credits

By

Healthwise Staff

Primary Medical Reviewer

Sarah Marshall, MD - Family Medicine

Specialist Medical Reviewer

William Gilbert, MD - Maternal and Fetal Medicine

References

Citations

American Institute of Ultrasound in Medicine (2007). AIUM practice guideline
for the performance of
obstetric ultrasound
examinations. Available online: http://www.aium.org/publications/guidelines.aspx.

Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

American Institute of Ultrasound in Medicine (2007). AIUM practice guideline
for the performance of
obstetric ultrasound
examinations. Available online: http://www.aium.org/publications/guidelines.aspx.

eMedicineHealth Medical Reference from Healthwise

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